Provider Demographics
NPI:1396908877
Name:STENZ, JULIETTE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIETTE
Middle Name:MARIE
Last Name:STENZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JULIETTE
Other - Middle Name:MARIE
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 FARM COLONY DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-5206
Mailing Address - Country:US
Mailing Address - Phone:814-726-2303
Mailing Address - Fax:814-726-7459
Practice Address - Street 1:2 FARM COLONY DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-5206
Practice Address - Country:US
Practice Address - Phone:814-726-2303
Practice Address - Fax:814-726-7459
Is Sole Proprietor?:No
Enumeration Date:2008-07-06
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263730207W00000X
PAMD448126207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03481445Medicaid
NY03481445Medicaid